Senate Democrats won a milestone victory early Monday in the health-care debate, approving a procedural motion to move the reform legislation to final passage later this week, and without a single vote to spare.

The 60-40 tally, taken shortly after 1 a.m., followed 12 hours of acrimonious debate and required senators to trek to the Capitol in the aftermath of a snowstorm. The vote was the first of three procedural hurdles that Democrats must cross before a final vote on passage of the measure, now scheduled for Christmas Eve.

A challenging closing round of negotiations, culminating in a series of compromises with moderates, threatened to overshadow the significance of what Democrats believed they were close to achieving: the most significant health-care legislation since Medicare and Medicaid were created in 1965.

“This bill is the product of years of hard work, study and deliberation,” said Senate Finance Chairman Max Baucus (D-Mont.), one of the principal sponsors of the package, in remarks on the Senate floor before the vote. “These are the reforms for which Americans have been waiting.”

Not a single Republican voted to advance the measure, including Sen. Olympia J. Snowe, the one GOP lawmaker who had backed an earlier version. The Maine moderate was lobbied heavily by President Obama, but announced Sunday night in a statement that she remained “concerned” about the measure, while objecting to “the artificial and arbitrary deadline of completing the bill before Christmas.”

Though admittedly outflanked, Republicans declined to relent. In the hours before the cloture vote, GOP lawmakers took turns condemning the bill in impassioned speeches on the Senate floor. Sen. Lamar Alexander (Tenn.) called it a “historic mistake.” Senate Minority Leader Mitch McConnell (Ky.) accused Democrats of producing “a mess” that represented “a blind call to make history.”

Sen. John McCain (R-Ariz.), who ran against Obama for president last year, vowed to “fight until the last vote,” a threat that could keep senators at their desks until well into the night on Dec. 24.

“They had 60 percent of the Senate, [but] 60 percent of the American people are against this,” McCain said Monday morning on “Good Morning America,” referring to polls showing that much of the public is skeptical of health-care reform. “They want it stopped.”

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